4

Measures and Measurements

Measures of Perceived Control, Mastery, and EmpowermentMastery. Pearlin
and Schooler (1978)xClose
Pearlin, L.I., and Schooler, C., (1978). The structure of
coping. Journal of Health and Social Behavior, 19,
2-21. developed a general perceived control
(mastery) scale consisting of seven items rated on
a 7-point Likert scale from "strongly agree" to "strongly
disagree." Sample items include, "I often feel helpless in
dealing with the problems of life," and "I have control over
the things that happen to me." As an example of research using
this scale, new mothers with higher levels of mastery were
more likely to engage in responsible maternal behavior two
years later and less likely to have further pregnancies in
that period (DeSocio,
Kitzman, & Cole, 2003xClose
DeSocio, J., Kitzman, H., & Cole, R. (2003). Testing the
relationship between self-agency and enactment of health behaviors.
Research in Nursing and Health, 26, 20-29. ).

Internality, powerful others, and chance. Levenson's
(1981)xClose
Levenson, H. (1981). Differentiating among internality, powerful
others, and chance. In H. M. Lefcourt (Ed.), Research
with the locus of control construct (Vol. 1, pp. 15-63).
New York: Academic Press. scale consists of 24
items measured on a 6-point response scale ranging from -3
(strongly disagree) to +3 (strongly agree). The scale includes
separate measures of internality (general
perceived control; 8 items), control by others
(8 items), and the effects of chance (8 items).
Sample items include: "When I make plans, I am almost
certain to make them work" (internality); "I feel
like what happens in my life is mostly determined by powerful
people" (control by others); and "To a great extent
my life is controlled by accidental happenings" (effects
of chance). General perceived control, as assessed with Levenson's
(1981)xClose
Levenson, H. (1981). Differentiating among internality, powerful
others, and chance. In H. M. Lefcourt (Ed.), Research
with the locus of control construct (Vol. 1, pp. 15-63).
New York: Academic Press. scale, has been found
to predict amplification-seeking among hearing- impaired individuals
(Cox,
Alexander, & Gray, 2005xClose
Cox, R. M., Alexander, G. C., & Gray, G. A. (2005). Who
wants a hearing aid? Personality profiles of hearing aid seekers.
Ear and Hearing, 26, 12-26. ).

Spheres of control. Paulus'
(1983)xClose
Paulhus, D. L. (1983). Sphere-specific measures of perceived
control. Journal of Personality and Social Psychology,
44,1253-1265. Spheres of Control
Scale (for more recent versions Spittal,
Siegart, McClure, & Walkey, 2002xClose
Spittal, M. J, Siegart, R. J., McClure, J. L., & Walkey,
F. H. (2002). The Spheres of Control scale: The identification
of a clear replicable three-factor structure. Personality
and Individual Differences, 32, 121-131. ) consists
of 30 items rated on a 7-point Likert scale from "strongly
agree" to "strongly disagree." The scale includes separate
measures of personal efficacy (10 items), interpersonal control
(10 items), and sociopolitical control (10 items). Sample
items include: "When I make plans I am almost certain
to make them work" (personal efficacy); "I have no
trouble making and keeping friends" (interpersonal control);
and "One of the major reasons we have wars is because people
don't take enough interest in politics" (sociopolitical control).
To date, no health behavior studies have been conducted using
this scale.

Multidimensional health locus of control. Wallston,
Wallston, and DeVellis' (1978)xClose
Wallston, K. A., Wallston, B. S., & DeVellis, R. (1978).
Development of the multidimensional Health Locus of Control
Scales. Health Education Monographs, 6, 161-170.
Multidimensional Health Locus of Control
scale is an 18-item measure of perceived control over health
outcomes measured on a 6-point Likert scale ranging from "strongly
disagree" to "strongly agree." The scale includes
separate measures of health-specific perceived control: internal,
chance, and powerful others; each assessed with 6 items. Sample
items include: "If I take the right actions, I can stay
healthy" (internal); "No matter what I do, if I am
going to get sick, I will get sick" (chance), and "My
family has a lot to do with my becoming sick or staying healthy"
(powerful others). This scale has been frequently used to
assess health locus of control. For instance, research with
the scale has found that Mexican American women who received
a health self-care manual coupled with seminars training them
on how to use the manual significantly increased in self-care
behavior and internal and powerful other health locus of control
(Kennedy,
DeVoe, Ramer-Henry, & West-Kowalski, 1999xClose
Kennedy, C. A., DeVoe, D., Ramer-Henry, K., & West-Kowalski,
J. (1999). Influence of self-care education on illness behaviors
and health locus of control of Mexican American women. Women
and Health, 28, 1-13. ).

Family empowerment. The Koren,
Dechillo, and Friesen (1992)xClose
Koren, P. E., Dechillo, N., & Friesen, B. (1992). Measuring
empowerment in families whose children have emotional disabilities:
A brief questionnaire. Rehabilitation Psychology, 37,
305-321. Family Empowerment Scale
consists of 34 items with a 5-point response scale "not
at all true" to "very true." A sample item is,
"I feel I can have a part in improving services for children
in my community." As an example of this scale's use, the
diabetic children of women with a stronger sense of empowerment
have better adherence to treatment (Florian
& Elad, 1998xClose
Florian, V., & Elad, D. (1998). The impact of mothers'
sense of empowerment on the metabolic control of their children
with juvenile diabetes. Journal of Pediatric Psychology,
23, 239-247. ).

Perceived Behavioral Control
Measures of perceived behavioral control
are usually devised by the researchers for a particular study,
though many studies use items similar to the ones developed
by Armitage
and Connor (1999)xClose
Armitage, C. F., & Conner, M. (1999). Distinguishing perceptions
of control from self-efficacy: Predicting consumption of a
low fat diet using the theory of planned behavior. Journal
of Applied Social Psychology, 29, 72-90. .
Examples of items from Armitage
and Connor (1999)xClose
Armitage, C. F., & Conner, M. (1999). Distinguishing perceptions
of control from self-efficacy: Predicting consumption of a
low fat diet using the theory of planned behavior. Journal
of Applied Social Psychology, 29, 72-90.
are "Whether or not I eat a low fat diet is entirely up
to me," and "How much personal control do you feel
you have over eating a low-fat diet?" In one longitudinal
study, perceived behavioral control predicted engagement in
physical exercise (Armitage,
2005xClose
Armitage, C. F. (2005). Can the theory of planned behavior
predict the maintenance of physical activity? Health Psychology,
24, 235-245. ).

Self-Efficacy
Self-efficacy, as originally conceived by Bandura
(1977)xClose
Bandura, A. (1977). Self-efficacy: Toward a unifying theory
of behavioral change. Psychological Review, 84, 191-215.
, is specific to a particular outcome. A large number
of self-efficacy scales that are specific to a particular
health behavior have been developed. Many studies have also
used items developed just for that particular study. See:
self-efficacy

Locus of ControlGeneral locus of control. Rotter's
(1966)xClose
Rotter, J. B. (1966). Generalized expectancies for internal
versus external control of reinforcement. Psychological
Monographs, 80 (1, Whole No. 609). I/E
Scale is a 29-item scale that assesses internal locus
of control with a forced-choice format pairing external and
internal control alternatives. A sample item pairing is, "I
have often found that what is going to happen will happen"
vs. "Trusting fate has never turned out as well for me as
making a decision to take a definite course of action." Smokers
who were more internal in LOC were more successful in their
efforts to stop smoking (Rosenbaum
& Argon, 1979xClose
Rosenbaum, M., & Argon, S. (1979). Locus of control and
success in self-initiated attempts to stop smoking. Journal
of Clinical Psychology, 35, 870-872. ). Interestingly,
it was difficult to locate recent (published in the past 20
years) health behavior studies that used general LOC. Almost
all studies used a general perceived control or health-related
LOC. measure. Rotter's scale is available in Robinson,
Shaver, and Wrightsman (1991)xClose
Robinson, J. P., Shaver, P. R., & Wrightsman, L. S. (1991).
Measures of personality and social psychological attitudes.
San Diego: Academic Press. .

Specific locus of control. There are several examples
of specific locus of control scales. Donovan
and O'Leary (1978)xClose
Donovan, D. M., & O'Leary, M. R. (1978). The drinking-related
locus of control scale: Reliability, factor structure and
validity. Journal of Studies on Alcohol, 39, 759-784.
have created a 25-item Drinking Locus
of Control scale rated on a forced-choice format
pairing internal and external control alternatives. A sample
pairing is, "I feel so helpless in some situations that I
need a drink" vs. "Abstinence is just a matter of deciding
that I no longer want to drink." Among a sample of women who
were recovering alcoholics, internal drinking locus of control
predicted abstinence from drinking, waiting a longer period
of time before starting to drink, drinking less on the first
occasion of drinking, and drinking for fewer consecutive days
(Koski-Jannes,
1994xClose
Koski-Jannes, A. (1994). Drinking-related locus of control
as a predictor of drinking after treatment. Addictive
Behaviors, 19, 491-495. ).

The four-item Weight Locus of Control scale,
developed by Saltzer
(1982)xClose
Saltzer, E. B. (1982). The Weight Locus of Control (WLOC)
Scale: A specific measure for obesity research. Journal
of Personality Assessment, 46, 620-628. , assesses
how one's weight is determined, ranging from internal to external
determinants. The scale is rated on a 6-point Likert scale
(strongly disagree to strongly agree). A sample item is, "Being
the right weight is largely a matter of good fortune." Among
those with an internal sense of weight locus of control, personal
attitudes towards weight loss predict weight loss intentions.
However, among those with an external sense of weight locus
of control, normative beliefs predict weight loss intentions
(Saltzer,
1981xClose
Saltzer, E. B. (1981). Cognitive moderators of the relationship
between behavioral intentions and behavior. Journal of
Personality and Social Psychology, 41, 260-271. ).

cognitive control of emotional and physiological responses (12 items);

application of problem-solving strategies (11 items);

ability to delay gratification (4 items); and

self-efficacy (9 items).

Examples of sample items are, "When I do a boring job,
I think about the less boring parts of the job and the reward
I will receive when I finish," and "When I am feeling
depressed, I try to think about pleasant events." Diabetic
women with greater self-control engaged in a greater number
of general health practices (e.g., exercise, nutrition). Self-control
mediated the effect of depression on health practices (Zauszniewski
& Chung, 2001xClose
Zauszniewski, J. A., & Chung, C. W. (2001). Resourcefulness
and health practices of diabetic women. Research in Nursing
and Health, 24, 113-121. ).

Realistic/Unrealistic ControlRealistic and unrealistic control. Zuckerman,
Knee, Kieffer, Rawsthorne, and Bruce's (1996)xClose
Zuckerman, M., Knee, C. R., Kieffer, S. C., Rawsthorne, L.,
& Bruce, L. M. (1996). Beliefs in realistic and unrealistic
control: Assessment and implications. Journal of Personality,
64, 435-464. Realistic and Unrealistic
Control Scales consist of 33 items measured on a
7-point Likert scale ranging from "strongly agree"
to "strongly disagree." Separate measures of realistic
(18 items) and unrealistic control (15 items) are obtained.
An example of a realistic control item is: "Success in
life depends mostly on how hard you study or work." An
example of an item measuring unrealistic control is: "There
is no such thing as misfortune; everything that happens is
the result of our own doing." A stronger sense of realistic
control was associated with less risky sexual behavior while
unrealistic control was associated with more risky sexual
behavior (Zuckerman
et al., 1996xClose
Zuckerman, M., Knee, C. R., Kieffer, S. C., Rawsthorne, L.,
& Bruce, L. M. (1996). Beliefs in realistic and unrealistic
control: Assessment and implications. Journal of Personality,
64, 435-464. ).

Illusory control. The Illusory Control Scale
by Friedland,
Kienan, and Regev (1992)xClose
Friedland, N., Kienan, G., & Regev, Y. (1992). Controlling
the uncontrollable: Effects of stress on the illusory perceptions
of controllability. Journal of Personality and Social
Psychology, 63, 923-931. assesses control over
uncontrollable events via hypothetical situations; for instance,
by asking the respondent to indicate whether they would rather
choose their own lottery ticket numbers or rely on the machine
to choose. The scale consists of 5 items assessed on a 10-point
Likert scale (e.g., "let the machine choose for me" to "choose
the ticket myself"). The Illusory Control Scale was associated
with greater use of illusory (i.e., ineffective) HIV-protection
strategies among college students and gay men in the community
(Thompson,
Kent, Thomas, & Vrungos, 1999xClose
Thompson, S. C., Kent, D. R., Thomas, Cr., & Vrungos,
S. (1999). Real and illusory control over exposure to HIV
in college students and gay men. Journal of Applied Social
Psychology, 29, 1128-1150. ).

Desire for Control/Preferences for InvolvementDesire for control. The Desire for Control
Scale (Burger
& Cooper, 1979xClose
Burger, J. M., & Cooper, H. M. (1979). The desirability
of control. Motivation and Emotion, 3, 381-393. )
consists of 20 items rated on a 7-point response scale from
"Does not apply to me at all" to "Always applies
to me." Sample items are, "I enjoy having control
over my own destiny," and "I enjoy being able to influence
the actions of others." Higher desire for control is positively
related to engagement in more health protective behaviors
(as cited in Burger,
1992xClose
Burger, J. M. (1992). Desire for control: Personality,
social, and clinical perspectives. New York: Plenum Press.
).

Desired control. Reid
and Zeigler's (1981)xClose
Reid, D. W., & Ziegler, M. (1981). The Desired Control
Measure and adjustment among the elderly. In H. M. Lefcourt
(Ed.), Research with the locus of control construct
(Vol. 1, pp. 127-157). New York: Academic Press. Desired Control Scale contains 70 items rated
on a 5-point response scale from "strongly agree"
to "strongly disagree." The scale consists of two
subscales: desire of outcomes (desired control; 35 items),
and beliefs and attitudes (which assesses control expectancy
of outcomes; 35 items). Sample items are: "How important
is it to you that you maintain your health?" (desired
control) and "I can rarely get out to do things I want"
(beliefs and attitudes). To date, no health behavior studies
have been conducted using this scale.

Decision involvement questionnaire. Thompson,
Pitts, and Schwankovsky (1993)xClose
Thompson, S. C., Pitts, J. S., & Schwankovsky, L. (1993).
Preferences for involvement in medical decision-making: Situational
and demographic influences. Patient Education and Counseling,
22, 133-140. have developed a measure of
decision involvement. Respondents read four
vignettes describing various medical problems and rate who
should make the treatment decision on a 5-point scale from
"the doctor alone" to "you alone." A sample vignette is, "Suppose
you fall and seriously injure your knee. There are two treatment
programs that are medically appropriate for your condition.
You can either have surgery that will be painful and require
bed rest for a month OR you can enter a twice-a-week rehabilitation
program for a year. Both have a 90% chance of success." Participants
had a stronger preference to be involved in medical decisions
that did not require medical expertise than those that did
require expertise (Thompson
et al., 1993xClose
Thompson, S. C., Pitts, J. S., & Schwankovsky, L. (1993).
Preferences for involvement in medical decision-making: Situational
and demographic influences. Patient Education and Counseling,
22, 133-140. ).

Control Strategies
The Health Engagement Control Strategies
(HECS; Wrosch,
Schulz, & Heckhausen, 2002xClose
Wrosch, C., Schulz, R., & Heckhausen, J. (2002). Health
stresses and depressive symptomatology in the elderly: The
importance of health engagement control strategies. Health
Psychology, 21, 340-348. ) is a nine-item measure
rated on a 5-point scale: "almost never true" to "almost
always true." Sample items include, "I invest as much
time and energy as possible to improve my health," and
"I do whatever is necessary to be as healthy as I possibly
can be." To date, no health behavior studies have been
conducted using this scale.